DUCTUS ARTERIOSUS CONSTRICTION - AN PRENATAL ULTRASOUND APPROACH

Abstract

Background: Ductus arteriosus constriction also known as premature closure of the ductus arteriosus is a significant narrowing of the open ductus arteriosus during pregnancy. The main cause of the disease is often due to maternal exposure to indomethacin or non-steroidal anti-inflammatory drugs, or due to the maternal consumption of foods rich in polyphenols.

Case presentation: A pregnant female patient underwent antenatal examination at the City International Hospital. At 29 weeks of gestation, during an ultrasound assessment, we noted a suspicious image suggestive of ductal constriction, including: a tortuous ductus arteriosus with a reversed S-shaped appearance, mild tricuspid regurgitation (grade 1/4), and a normal peak systolic velocity (PSV) across the ductus arteriosus at approximately 105 cm/s. The patient was scheduled for follow-up visits at 31 weeks 5 days, 35 weeks, and 36 weeks 5 days of gestation. Ultrasound evaluations were performed to monitor changes in blood flow through the ductus arteriosus, tricuspid valve, and signs of cardiac overload.

Conclusion: When ductus arteriosus constriction is diagnosed, monitoring the progression of the disease as well as accompanying cardiac complications is important. In severe cases, termination of pregnancy at any gestational age must be performed. Collaboration between obstetrics and neonatology as well as postnatal care and monitoring is essential to achieve the best outcome for the baby.

Keywords: ductus arteriosus constriction; reverse S-shaped ductus arteriosus; polyphenol rich foods